Report: Hospitals Overpay for Health IT When Systems Don’t Connect

“Interoperability” is key to successful clinical care

Seriously ill patients on breathing machines can have their chances for survival increased from 60% to 70% if the machines are programmed to deliver enough life-sustaining breaths, but not so much that it damages lungs by overinflating them. In some hospitals, however, fewer than 20% receive this life-saving intervention, according to an article in the Harvard Business Review. One major reason why is that hospitals purchase technologies without requiring that they communicate with each other.

For years, hospitals have invested in sophisticated devices and information technology (IT) systems that, on their own, can be awe-inspiring, and yet these technologies rarely share data, let alone leverage them to support better clinical care, the article contends. There are a couple of reasons for this state of affairs.

First, the number of devices that work well with others is small, the authors point out. Manufacturers have been slow to embrace interoperability, which would allow health care technologies to share data with one another. In recent years, however, there has been movement to change that. More companies have pledged to open their data, giving innovators the chance to mine that information and use it to drive improved care.

Second, the article asserts, health care lacks widespread adoption of interoperability standards that govern formats and elements of data shared between different systems. Without such standards, data cannot be shared and understood among devices. The National Academy of Medicine is developing a report that will identify the barriers to widespread interoperability and that will suggest opportunities to overcome them, such as policies, requirements, standards, and purchase specifications.

“Part of the solution must involve hospitals,” the authors write. “If they truly want technologies that save lives and boost productivity, they will need to exert their considerable pressure as purchasers, requiring that manufacturers embrace openness and interoperability, and only purchasing devices that support this. Too often, hospitals treat equipment and IT procurement in a siloed way, focusing on price without looking at how those devices will work as part of a larger system.”

For example, the authors note, many new hospital beds come with a sophisticated array of sensors that can track such information as whether a patient is at risk of developing a bedsore, based on data about how often they move in bed. Such sensors may be 30% of a bed’s costs, but at one of the authors’ hospitals, those data are unusable—they are in a format that the hospital’s IT system can’t read.

Similarly, much of the data that are fed from wireless monitors of patients’ heart rate, blood oxygen levels, blood pressure, and breathing rate don’t link to medical records.

In short, health care is woefully under-engineered, the authors contend. Too often, clinicians mold their work processes around the demands of multiple devices and health IT systems, and yet those technologies don’t work together to serve their needs and the needs of patients.

The authors suggest that “hospitals could work together, writing specifications and functional requirements for the products that they will purchase and refusing to do business with manufacturers that don’t comply. Group purchasing organizations, which help procure products and devices for thousands of hospitals under their umbrella, might also fill that role.”

Moreover, they write, “rather than looking to assemble hospital rooms one product at a time, hospitals should be able to purchase modules––sets of interoperable products that work together to support an aspect of care.

“This model makes sense,” the authors add, “as few if any hospitals have the resources to design and manage all the connections between technologies, or to optimize how the data are used and displayed to support top-quality care. Ultimately, when a hospital is built or renovated, it would have the option to buy modular patient rooms, clinical units, or floors—a ‘hospital in a box,’ built to its specifications.”

Source: Harvard Business Review; June 13, 2017.